Introduction

Thyroidectomy is a surgical process that involves removal of all or parts of the thyroid glands, whereby the process is aimed at treating thyroid disorders such as cancerous or non cancerous enlargement of the thyroid (goiter). Like any other surgery, the process has aftermath effects on the body, as the patient goes through the healing process and this paper will focus on the medical recommendation, for pain in the neck after the surgery.

Medical Condition

Pain in the neck after Thyroidectomy has been associated with several factors; the position of the neck during and after the surgery can cause the pains. During this surgery the neck is mostly extended during the surgery and in the process a nerve in the head known as the greater occipital nerve might be compressed. The second factor that may cause these pains could be the positioning of the neck after Thyroidectomy, in my case the patient told me that she had a tendency of positioning the neck in one position after the surgery and in the process she felt the neck stiff. On top of the pain killer I prescribed to her, I asked her to be moving her neck and shoulders as soon as her surgeon cleared her to do so. Medical experts have come up with both pharmacological and non pharmacological remedies to handle the condition; patients are advised to use NSAIDs (non steroidal anti inflammatory drugs) such as ibuprofen (Motrin, Advil), medication with regard to pain (Shah, et al., 2015). Non pharmacological prescriptions include eating lots of fresh fruits and vegetables as well as taking a lot of water. My 30 year old patient suffering from neck pain after Thyroidectomy, will be put under Motrin prescription which is a non steroidal anti inflammatory drug that is suitable for adults and young children at least 6 years old.

My patient is 30 years old and that makes her less prone to risks of stroke that may be caused by Motrin, it has been recorded before that the drug is a risk factor for stroke or heart attacks especially when used by elderly people. I prescribe Ibuprofen because it has been found to relieve pain, tenderness, swelling and stiffness caused by rheumatoid and osteoarthritis as compared to strong narcotic drugs. The drug is in a class of medications called NSAIDs and it works by preventing the body from producing substances that bring about pain, fever as well as inflammation (Rainsford, 2013). My patient will take the drug through a 400 mg tablet to be taken by mouth, whereby she will take it 3 times a day, on a span of between 4 to 6 hours in a day; this will translate to 3 doses a day for 4 days (Regmi, et al., 2014). My patient is supposed to take the medicine with food or milk and this is expected to prevent stomach upsets, for this reason the medicine should be taken during breakfast, lunch, 4pm tea and supper. After checking the health and lifestyle records of my patients; this drug will be the best because she does not take alcohol and has no health records of ulcers, nonetheless, the patient does not take blood thinners or steroids and she is not currently pregnant or breast feeding.

Non Pharmacological Processes to treat Neck Pains after Thyroidectomy

After Thyroidectomy, the patient is guided on the way to manage the condition and this involves techniques to keep the wound healthy and this will mean a reduced chance of neck pains. The sleeping position on the bed must be looked at carefully, I advised raise the head of her bed 30 – 40 degrees or sleep on a recliner for 3-4 days after surgery; this would help to reduce swelling. The patient should also keep the incision dry by using Q-tips or gauze that has been tipped in a ½ hydrogen peroxide and ½ water mixtures to wipe away blood over the wound. Keeping the incision dry will ensure a healthy wound and as a result the chances of pain are likely to occur (Tala, & Tuttle, 2010). Some patients are discharged with a thin drain tube known as JP drain, whereby the patient is trained sufficiently on how to manage it before they leave the hospital. The liquid coming from the drain should be red, pink or straw colored, but if the fluid dripping is milky or looks like pus, the patient must see the surgeon. Managing the JP drain in the right manner enables the patients to live a comfortable and less painful life. To speed up the healing process, the patient is advised to be doing neck exercises and this include turning the neck to look over one head until they feel the beginning of a stretch, this should be repeated to the right and left with each turn taking three to five counts. Other exercises include head tilts until stretch is felt, shoulder shrug, shoulder squeeze, forward arm raise, and side arm raise.

Conclusion

Neck pains after Thyroidectomy are common and therefore patients must be prepared to deal with the condition. Ibuprofen is one among many medicines that can be used to take care of the pains; nonetheless the choice of drug to be used must be considerate of both the health and lifestyle records of the patients. The age of the patient must also be considered, since most of the painkillers can have serious effects on elderly patients and this may include stroke or heart attacks, therefore settling on this drug was motivated by the age of the patient. Other pharmacological and non pharmacological ways of managing the situation are used, for example exercises, sleeping positions, management of the incision and JP drain pipe.

References

Rainsford, K. D. (2013). Ibuprofen: pharmacology, therapeutics and side effects. Springer Science & Business Media.

Regmi, D., Toran, K. C., Bista, M., & Shrestha, S. (2014). Comparison of surgical outcomes of Ultrasonic technique (Harmonic Focus™) with Conventional technique in open hemithyroidectomy. Journal of Kathmandu Medical College, 2(4), 175-180.

Shah, K. K., Tarasova, V., Davidian, M., & Anderson, R. J. (2015). Painful acute radiation thyroiditis induced by 131I treatment of Graves’ disease. BMJ case reports, 2015, bcr2014207670.

Tala, H., & Tuttle, R. M. (2010). Contemporary post surgical management of differentiated thyroid carcinoma. Clinical Oncology, 22(6), 419-429.

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